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Introduction

The landmark Scandinavian Simvastatin Survival Study (4S) published in 1994, may well be remembered as the study that finally put to rest many of the apprehensions and misconceptions regarding lipid-lowering therapy.

Modern epidemiological studies have established the facts that elevated plasma cholesterol causes pathological changes in the arterial wall leading to CAD, and that lipid-lowering therapy results in reduction of coronary and cerebrovascular events with improved survival.

These studies, which can be summarised by their acronyms—4S,2 PLACI,3 PLACII,4 ACAPS,5 KAPS6 and REGRESS7—all reinforce the benefits of lipid-lowering therapy for dyslipidaemia and the primary prevention of coronary heart disease (CDH).